Table 3.

ICERs for Each Strategy, by Age and Previous Fracture Status*

Age, y	ICER, by Previous Fracture, $/QALY
	No Previous Fracture†		Previous Fracture
	Test and Selective Alendronate Therapy	No Test and Universal Alendronate Therapy	Test and Selective Alendronate Therapy	No Test and Universal Alendronate Therapy
60	156 900	470 300	19 600	119 000
65	95 500	283 000	8500	72 300
70†	66 800	178 700	6300	44 500
75	46 900	103 000	5700	17 300
80	37 200	61 500	Dominated‡	2300

ICER = incremental cost-effectiveness ratio; QALY = quality-adjusted life-year.

^*ICER was measured by cost per QALY gained. The no test–no alendronate strategy was the reference strategy because it was the least costly, viable (nondominated) option. The strategy was considered cost-effective if its ICER was less than $100 000 per QALY gained (32, 63).

^†Base-case assumptions.

^‡Universal alendronate therapy without a bone mineral density test dominated this strategy by simple dominance because it was less effective and more costly.